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Clinicopathologic characteristics of HER2-positive pure mucinous carcinoma of the breast
장윤정,정혜라,김한나,서유정,Emad Alsharif,남석진,김석원,이정은,박연희,조은윤,조수연 대한병리학회 2020 Journal of Pathology and Translational Medicine Vol.54 No.1
Background: Pure mucinous carcinoma (PMC) is a rare type of breast cancer, estimated to represent 2% of invasive breast cancer. PMC is typically positive for estrogen receptors (ER) and progesterone receptors (PR) and negative for human epidermal growth factor receptor 2 (HER2). The clinicopathologic characteristics of HER2-positive PMC have not been investigated. Methods: Pathology archives were searched for PMC diagnosed from January 1999 to April 2018. Clinicopathologic data and microscopic findings were reviewed and compared between HER2-positive PMC and HER2-negative PMC. We also analyzed the differences in disease-free survival (DFS) and overall survival according to clinicopathologic parameters including HER2 status in overall PMC cases. Results: There were 21 HER2-positive cases (4.8%) in 438 PMCs. The average tumor size of HER2-positive PMC was 32.21 mm (± 26.55). Lymph node metastasis was present in seven cases. Compared to HER2-negative PMC, HER2-positive PMC presented with a more advanced T category (p < .001), more frequent lymph node metastasis (p = .009), and a higher nuclear and histologic grade (p < .001). Microscopically, signet ring cells were frequently observed in HER2-positive PMC (p < .001), whereas a micropapillary pattern was more frequent in HER2-negative PMC (p = .012). HER2-positive PMC was more frequently negative for ER (33.3% vs. 1.2%) and PR (28.6% vs. 7.2%) than HER2-negative PMC and showed a high Ki-67 labeling index. During follow-up, distant metastasis and recurrence developed in three HER2-positive PMC patients. Multivariate analysis revealed that only HER2-positivity and lymph node status were significantly associated with DFS. Conclusions: Our results suggest that HER2-positive PMC is a more aggressive subgroup of PMC. HER2 positivity should be considered for adequate management of PMC.
장윤정,Chang, Yoon-Jung 한국호스피스완화의료학회 2012 한국호스피스.완화의료학회지 Vol.15 No.4
말기암환자에 대한 완화의료의 중요성은 세계적으로 강조되고 있다. 이에 우리나라에서는 암정복10개년계획을 수립하면서 암에 대한 정책을 기획하였고, 추진되었다. 말기암환자 완화의료사업에 대한 법적 근거를 제시하는 암관리법과 제2기 암정복10개년 계획의 내용을 통해 현재 우리나라의 호스피스 완화의료 제도화 현황을 확인해보고자 한다. 호스피스 완화의료의 제도화는 국가암관리사업의 커다란 틀 안에서 발전되어 왔다. 완화의료기관의 확대 및 전문인력 양성과 질적 향상 등에 대해 2013년 완화의료 수가 본 사업이 시작된 이후에도 호스피스 완화의료의 지속적인 발전을 위하여 발전해야 할 것이다. The importance of palliative care for terminal cancer patients has been emphasized globally. Korea has formulated and implemented its policy for cancer control as it drew up a 10-year plan for cancer patient care. We examined Korea's National Cancer Act and the second 10-year plan for cancer patient care, which are legal grounds for palliative care projects for terminal cancer patients, to check the current status of Korea's efforts to establish a hospice and palliative care system. Institutionalization of hospice and palliative care has been developed within a framework of the national cancer project. Efforts such as expansion of hospice units, experts training and quality improvement should continue after the reimbursement of hospice and palliative care begins in 2013.
장윤정,김형섭,민회식,이창한,오민균,이은신,신희석,윤철호 대한근전도전기진단의학회 2020 대한근전도 전기진단의학회지 Vol.22 No.1
We report a case involving a 71-year-old female patient with rheumatoid arthritis who presented with severe back pain, symmetrical distal lower limb pain and sensory abnormalities in her distal lower limbs for 2 months. Electrodiagnosis was performed and then diagnosed as multiple lumbosacral radiculopathies and peripheral polyneuropathy. After about 2 weeks, motor weakness and sensory loss in the lower extremities worsened. Mononeuritis multiplex was diagnosed on a follow up electrodiagnosis. Thereafter, the patient was transferred to rheumatology department for treatment. Steroid pulse therapy was attempted, however, due to complication after the first session, the treatment was not completed. After 10 months, there has been no change in the patient symptoms of distal limb weakness and sensory loss. This is a case of mononeuritis multiplex that was misdiagnosed multiple lumbosacral radiculopathies in a patient with rheumatoid arthritis.